About postnatal psychosis

Postnatal psychosis involves a significant change in a person’s thinking, behaviour and emotions. It usually begins within the first four weeks after birth but can start up to twelve weeks postpartum. For some people it is the first time they have ever experienced psychosis. For others it may be linked to a history of bipolar disorder or an earlier episode of psychosis.

During a psychotic episode a person may lose touch with reality. They might see or hear things that are not there or hold unusual beliefs. They may appear confused or distressed. They might talk in ways that seem disorganised or hard to follow. They may swing between different moods or become extremely energised or withdrawn. These changes can happen very quickly.

Postnatal psychosis can impact a person’s ability to sleep, care for themselves and care for their baby. It is not anyone’s fault. It is a serious health condition that requires urgent attention and a supportive, non judgemental response from those around them.

The early signs of postpartum psychosis can appear suddenly. Many families first notice dramatic changes in sleep and behaviour. Some people go days without sleeping. Others may become highly energised or confused. They might express unusual thoughts or beliefs. They may withdraw from loved ones or show distress that seems out of character.

Changes may include:

• Sudden shifts in mood or energy
• Confusion or difficulty thinking clearly
• Rapid or disorganised speech
• Unusual beliefs or perceptions
• Loss of interest in daily activities
• Difficulty caring for the baby
• Frightening thoughts about self harm or harm to the baby

These changes can look different from day to day. A person may appear settled for a moment then become distressed again. This does not mean they are choosing these behaviours. It is a sign of the illness.

Recovery time is different for everyone. Some people begin to improve within weeks. Others need longer support. Symptoms may come and go during early recovery. This is normal and does not mean recovery is not happening.

Early treatment gives the best chance of a quicker and safer recovery.

Postnatal psychosis can happen to any woman or birthing parent after childbirth. For some people early parenthood is the first time they experience psychosis. Some factors may increase risk.

These include:

• A diagnosis of bipolar affective disorder
• A family history of bipolar disorder, psychosis or schizophrenia spectrum disorders
• A previous episode of postnatal psychosis
• Severe insomnia after birth
• Being a first time parent
• A personal history of psychosis
• Feeling unable to sleep after birth: Severe, persistent insomnia in the days/weeks after birth.
• Being a first-time mother.

Postnatal psychosis is a medical emergency. Early support is essential. Many people who experience psychosis do not realise they are unwell which means partners, friends or family often take the lead in seeking help.

You can:

• Call PANDA’s National Perinatal Mental Health Helpline on 1300 726 306
• Speak to a GP or maternal and child health nurse
• Call your state or territory mental health line
• Go to your nearest hospital emergency department
• Call 000 if you are worried about immediate danger

When speaking to health staff explain what you have noticed. Let them know the person has a young baby and that you are concerned about postnatal psychosis.

My mum decided to call the mental health team. It was the safest decision because I was not in a position to understand the risk I was in.

If you need help now, call your state's mental health crisis line for immediate expert support. They will help you work out which services can best help. This could be the doctor, a hospital emergency department or a community mental health service. Sometimes, the mental health emergency response team will be sent to you or your loved one, wherever you are.

ACT: 1800 629 354 FREE — Mental Health Triage Service

NSW: 1800 011 511 FREE — Mental Health Line

NT: 1800 682 288 — Northern Territory Mental Health Line

SA: 13 14 65 FREE — Mental Health Triage Service

TAS: 1800 332 388 FREE — Mental Health Service Helpline

WA: 1800 676 822 FREE — Mental Health Emergency Response Line
(Metro – 1300 555 788 Rural 1800 552 002)

Postnatal psychosis affects the whole family. Partners often describe feeling frightened and unsure what to do. Family members may feel distressed about what they are seeing. They may worry about the safety of the person and the baby.

It can help to remember:

• Postnatal psychosis is treatable
• You did not cause this
• Your support can make a difference
• Help seeking is essential
• Recovery often takes time and patience

Families may also need counselling or support to help them cope. Older children may need reassurance and guidance.

Many people who experience postnatal psychosis can go on to have more children. With preparation and support it is possible to make informed decisions about future pregnancies.

Thoughts of suicide are common during pregnancy and the first year of a baby’s life.

If you're supporting someone having thoughts of suicide, it's important to know that talking about suicide doesn’t increase the risk that someone will attempt to take their own life – but it can increase safety by reducing feelings of isolation and hopelessness.

For support, you might like to talk to:

• A trusted loved one (your partner, a family member or friend).
• One of PANDA’s Helpline telephone counsellors.
• A health care provider (GP, social worker, psychologist, psychiatrist).
• A suicide support crisis line.